Gastroenterology and Hepatology

Abdominal ultrasound is a method that requires a rather long learning period but, in expert hands provides, without any harm to the patient, real-time elements, to be possibly confirmed by "second level" exams such as CT scan, MRI or endoscopy. Today, medical ultrasound is no longer considered a new technology, as it has been used extensively for over 30 years. However, if we consider the large technological improvements that have implemented this method, I believe that something new can still tell us. From a purely radiological and surgical tool, ultrasound has now become a quick and painless diagnostic tool used by specialists from different branches, such as cardiology, angiology, urology, gynecology, obstetrics, orthopedics, emergency medicine and gastroenterology. Regarding the latter specialization, I like to say that “the ultrasound device is the gastroenterologist's stethoscope”. In fact, not disdaining the semeiotics that must be the essential baggage of every doctor, I feel I can say that the ultrasound physical examination is often more accurate than the physical examination. For example, small liquid effusions in the abdomen are not detectable by physical examination, nor are nodules (benign or malignant) of the liver, pancreas and spleen. Similar consideration for the pathological increases in volume of the deep lymphnodes and for the thickening of the intestinal walls of an inflammatory or neoplastic nature. Let's not forget that the gastroenterologist is fully a physician, so during an ultrasound examination he does not disdain the observation of the large abdominal vessels (aorta in particular), the kidneys, the bladder or the internal genitals. The subsequent involvement, in the case of suspected non-hepato-gastroenterological disease, of the most suitable specialist, is obvious.